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General NPI Number Information
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NPI Number | 1902095441
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Entity Type | Individual
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Provider Name | SUSAN WASNER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 50 E NORTH ST
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City | BUFFALO
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State | NY
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Zip | 14203-1002
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Country | US
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Telephone | 716-885-8318
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Fax | 716-885-0229
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Provider Business Mailing Address
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Address Line | 617 CRESCENT AVE
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City | EAST AURORA
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State | NY
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Zip | 14052-2903
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Country | US
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Telephone | 716-348-7530
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 010805-1
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License Number State | NY
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